紫杉醇联合草酸铂治疗复治晚期非小细胞肺癌的疗效

Efficacy of Combined Paclitaxel and Oxaliplatin Therapy in Patients with Pretreated Advanced Non Small Cell Lung Cancer

背景与目的目前临床上对绝大多数复治晚期非小细胞肺癌(non-smallcelllungcancer,NSCLC)患者缺乏有效的治疗方法和药物,本研究应用紫杉醇和草酸铂两药联合化疗,旨在探讨该方案的临床疗效及不良反应。方法22例患者均为复治晚期NSCLC。化疗方案为紫杉醇135mg/m2,静滴≥3h;草酸铂130mg/m2,静滴≥2h,均在第一天完成,28天为一周期,连用2周期为一个疗程。结果在22例患者中,PR5例,有效率为22.7%。所有病例中,除3例出现疾病进展外,其余均可见病灶好转或稳定。中位缓解期4个月,中位生存期8个月。主要不良反应按WHO标准,Ⅲ度发生率分别为恶心呕吐9.1%、肌肉关节疼痛13.6%、脱发63.6%和骨髓抑制4.5%,仅2例发生Ⅳ度恶心呕吐,经对症处理或治疗结束后自行缓解。结论紫杉醇联合草酸铂治疗晚期NSCLC有一定疗效,其毒性患者可以耐受,为晚期非小细胞肺癌提供了一种切实可行的治疗方案。

BACKGROUND &OBJECTIVE: No chemotherapeutic regimen and agent are effective for patients with pretreated advanced non small cell lung cancer (NSCLC). This study was designed to evaluate the efficacy and toxicity of the combination of paclitaxel and oxaliplatin in this subset of patients. METHODS: Twenty two patients who had been pretreated with platinum based chemotherapy were enrolled into this study. All received paclitaxel (135 mg/m2, intravenous infusion over 3 hours on day 1) and oxaliplatin (130 mg/m2, intravenous infusion over 2 hours on day 1) every 28 days. The whole course of treatment consisted at least 2 cycles. RESULTS: Of 22 patients, 5 achieved partial response with the overall response rate of 22.7%. Nearly all lesions shrank or remained stable after the first 2 cycles, except for those of 3 patients who showed progressive diseases. Median progression free duration time was 4 months, and median survival time was 8 months. Commonly encountered toxicities included nausea and vomiting, myalgia/arthralgta, peripheral neuropathy, and myelosuppression. CONCLUSION: Paclitaxel plus oxaliplatin combination was a safe and active regimen for patients with pretreated advanced NSCLC and deserves further evaluation.